Tuesday, August 03, 2021

Does your IVF doctor give cuts and kickbacks to get referrals ? [Video]

 

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Monday, August 02, 2021

Why are IVF patients so proud of their ignorance ?


 
 

Many patients who have failed an IVF cycle ask me for a free second opinion by email , which we offer on our website at www.drmalpani.com

I ask them basic questions , such as - What medications were used for superovulation ; or what the quality of their embryos was , and they are often completely blank . They don’t know this basic information , and this always surprises me , because I can't believe IVF  patients will spend so much time , money and energy on doing such an important treatment without actually doing their homework . You need to do your research , so you know what the right questions are, and can get answers to them.

While it’s true that doctors are very busy people , and often will not entertain their patient’s questions , it is equally true that it is in the patient’s best interests to be well informed , so they know exactly what's happening .

This is why your doctor’s website is often a better source of information than your doctor . You are understandably reluctant to ask your doctor questions during the consultation, because you are worried that he many get irritated if you ask him any. Also, you are reluctant to waste his time by asking him questions , because there is a long line of patients waiting to see him ; and you are worried that your questions may appear to be stupid .

The doctor’s website, on the other hand, is extremely patient, and will allow you to ask as many questions as you like , and will answer them for you as well !

While it maybe true that the doctor is reluctant to share information with you because it allows him to hide his incompetence, you have no excuse for choosing to remain ignorant .

This kind of information asymmetry is harmful for patients , and that's why you need to do your homework before starting your treatment.

While it’s it's true that there is a lot of high quality information available on the web it's also equally true that there is even more poor quality, unreliable and outdated information available online as well.

The best way to differentiate between high-quality information and poor-quality information is to study lots of information , so that you learn what is reliable and what is a lie.

Remember that the quality of the information on a clinic’s website is often likely to be far better than what your doctor will tell you .  He may have a vested interest in not sharing the truth with you during a consultation, because he is trying to sell his services, and he can get away with making tall claims within the four walls of his clinic , but it's much harder for him to lie on a website where the information is publicly accessible , and he will get pulled up if he lies.

You need to have a strategy for evaluating information, because there is so much of it. The good thing about being a patient is you can be patient. You have a lot of time to access this information , and it's in your best interest to do your homework before starting an IVF cycle , rather than leave everything up to the doctor

 

Don't allow your IVF doctor to cheat you ! [Video]

 

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 Need help? We provide a second opinion on all infertility issues. Please send us your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so that we can guide you better.

Sunday, August 01, 2021

Artificial Insemination ( AIH) at home as an alternative to IUI in the clinic



For many infertile couples , a very effective and simple treatment option is called IUI – also know as IntraUterine Insemination or AIH - Artificial Insemination by Husband . This is especially useful in couples with unexplained infertility ( where we cannot find a medical reason for why they are not getting pregnant in their bedroom); and for those with sexual dysfunction,  where they cannot consummate the marriage because of vaginismus, erectile dysfunction ( ED or impotence) ; or premature ejaculation.

In all these patients, artificial insemination allows us to bypass the natural sexual process , because we can deposit the sperms in the woman directly .

In an IUI cycle, the sperms are processed in the laboratory , where they are cleaned and concentrated; and the doctor inserts these inside the uterine cavity before , or just after ovulation – at the time of your peak fertility. This is much less expensive than IVF treatment, and conceptually it allows us to increase the chances of the egg and sperm meeting.

For patients, doing an artificial insemination is costly, and can be emotionally extremely stressful. Doctors charge money, and it’s no fun to take time off work, and then go to the doctor’s clinic, and wait endlessly for your appointment . Lying down in the scan room, with your legs up in the air , while someone puts a probe into your vagina is hardly fun . Doctors often treat scans as “routine” , and some can be quite rough, which makes the scans painful as well. Having to make make repeated visits during a treatment cycle adds to your stress , and your costs.

What’s worse is you are completely clueless about what’s happening and why. Doctors aren’t communicative, and you don’t know if your cycle is progressing well or not , because they don’t share information. Also, each part of the IUI treatment is done by a different doctor, some of whom are in different locations, which means you need to run around from one doctor to another. The doctor who does the scans – a sonographer , is often not your gynecologist, and finally when the follicle ruptures ( you ovulate), your husband needs to provide the semen sample in the laboratory which processes the sperm sample, and then delivers it the clinician for the actual insemination.

There is often complete lack of coordination between the scan centre , the clinic , and the lab , and patients often have to run around between them. This can be very frustrating , and getting your husband to take time off work to provide a semen sample on demand is also very challenging.

The good news is a much simpler and much less expensive option is to actually do the artificial insemination at home yourself,

A simple way of doing this is using the self insemination kit which we provide.

This allows you to do the insemination in the privacy of your own bedroom . Since you are monitoring your own ovulation cycle , you don’t need to waste time and money going to the clinic , which means doing a self insemination becomes inexpensive , and very cost effective .

Finally, do have realistic expectations regarding success rates please ! Human reproduction is not very efficient, and even fertile couples take time to make a baby in the bedroom, so you do need to be patient. The chances of success if everything is normal, and you do the procedure properly, is about 40% in 4 cycles.

 

 

The two questions you need to ask to find the right IVF doctor for your IVF treatment without spending any money

 


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Saturday, July 31, 2021

How to find the best IVF doctor - a guide for IVF patients? [Video]

 


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What IVF patients need to do to stop remaining confused and ignorant

 


It both amazes and dismays me how poorly informed IVF patients are,  even after they have completed an IVF cycle . 

I know this because I offer a free second opinion by email on our website at www.drmalpani.com. Patients ho have failed an IVF cycle can send me their IVF medical records , so I can review them and guide them as to what they can do to maximize their chances of success in the next cycle.

I request them to send me photographs of their embryos, so I can assess the quality of their medical care . After all, the only tangible deliverable an IVF Clinic can provide is embryos, and top quality embryos means your clinic did a good job with your medical treatment.

After all, the only thing an IVF clinic can do is make embryos. Whether they implant after the transfer is not something which anyone can control, because embryo implantation is still a Black Box which we don’t understand well.

Embryo quality is tangible , and because it can be objectively documented as a photo, it’s reliable and can be trusted.

However, patients often reply to my request by saying – The doctor did not give us a photograph of the embryos ; I did not know that the doctor was supposed to give me photos of my embryos. Even worse, they will send me a photograph of the ultrasound scan which the doctor did while doing the ultrasound-guided transfer . The reason this upsets me is because this clearly means they don’t understand what embryos look like .

This means that not only did they not bother to do their research before starting their IVF treatment, their doctor did not bother to educate them , and has chosen to hide information from them, for reasons best known to him.

I worry when doctors aren’t transparent – what are they hiding, and why ?

This is why patients need to address the problem of Information asymmetry proactively .

Please do your homework before you start your IVF cycle , rather than kick yourself after the cycle has failed , that you didn’t take the time and trouble to get the information you required from your doctor !

And if you want to know what embryos look like , check out www.drmalpani.com/knowledge-center/ivf/embryos

 

 

Friday, July 30, 2021

Knowledge is Power for IVF Patients - the Importance of Information Therapy



 IVF patients are often confused as to whether they should look for information online for themselves.

After all, we all know  that half knowledge is dangerous , and that it’s not a good idea to try to treat yourself . After all, your doctor is the medical expert – why not let him make all the decisions ? After all, he comes highly recommended – and aren’t you paying him enough ? Why not let him do his job, instead of trying to second guess him ?

Many husbands discourage their wives from spending time on the Internet , because they feel that get completely obsessed with this exercise. They waste so much time online, looking for information - and then get completely confused , because so much of the information is unreliable and contradictory . They often end up worse off than before they started searching, because they don’t know whom or what to trust !

Also, internet positive patients often end up irritating doctors , who feel that patients are trying to act extra smart . They don't really want to answer the patient’s questions , because this takes them too much time and energy .

The truth is that you need to learn how to search the Internet properly .

Reliable information is invaluable , because it reduce your stress levels .

A huge problem which plagues IVF is the uncertainty which surrounds it, and this creates a lot of anxiety , because you don't know what is going to happen next . The fear of the unknown often puts patients off from even starting an IVF cycle, because of all the horror stories they have heard about side effects and complications.

Also, even if you do screw up your courage and start the cycle, you are often flying blind during your treatment, because the doctor often refuses to share information, and being in the dark can be very uncomfortable ! Is your cycle going well ? Can the doctor do something to improve your chances ? Is it only the assistants who are making all the medical decisions ?

On the other hand , if you are well informed , you are in control, because you know what's happening , and what to expect next. You can have intelligent discussions with your doctor , and ask intelligent questions . Remember, Knowledge is Power, and it’s much easier to deal with the ups and downs of the IVF roller coaster ride if you know what to expect.

The secret is to become a well-informed internet searcher, and it's helpful to remember that not all websites are created equal .

If you are looking for reliable information on IVF , please go to www.drmalpani.com.

This is information we have authored personally , and I can guarantee you that this information is easy to understand, updated and reliable

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !






Can you trust your IVF doctor ? [Video]

 

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Thursday, July 29, 2021

Tuesday, July 27, 2021

Doctor, my HCG level is 120 mIU/ml. Does this confirm my pregnancy is healthy ? [Video]

 

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Sunday, July 25, 2021

The problem with travelling embryologists and why this compromises IVF care [Video]

 

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Saturday, July 24, 2021

Do not allow your IVF doctor to do a Day 3 or Day 2 transfer for you [Video]

  






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Need help? We provide a second opinion on all infertility issues. Please send us your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so that we can guide you better.

Friday, July 23, 2021

Why do doctors continue transferring more than one embryo ? The danger of IVF twin pregnancies

 

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Thursday, July 22, 2021

Wednesday, July 21, 2021

How much will a second IVF cycle cost ?

 

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Endometriosis and Infertility. Comic/InfoGraphic

Tuesday, July 20, 2021

Sunday, July 18, 2021

Saturday, July 17, 2021

The endometrium and infertility - what every infertile couple needs to know about the uterine lining?

 

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Friday, July 16, 2021

The paradox of unexplained infertility - treatment is easier than diagnosis !

 

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Why do IVF labs continue to transfer embryos on Day 2 and Day 3 ?



If your IVF lab transfers embryos on Day 2 or Day 3, this is a red flag, and suggests the lab is incompetent, and doesn't have confidence in its ability to grow embryos in vitro

Embryologists scare patients by saying - " Keeping embryos for two more days in lab is risky. When there are only a few embryos , growing them to blastocyst may be suicidal , as none of them may survive"

The truth is that embryos don't and can't commit suicide. It's the poor conditions in a bad lab which kills them. These labs can't grow embryos well in their incubator

If they can't grow them well to Day 5, then it's highly likely that when they grow them to Day 3, these embryos are already compromised because of poor culture conditions, and are unlikely to implant. However, if they don't implant after the transfer, the clinic can blame the patient for the "failed implantation", and thus pass the buck !

Don't let the IVF clinic bully you ! Yes, there is a risk they may arrest in vitro and you may not end up with any embryos to transfer, but it's best to know this in advance, rather than spend the 2ww in pointless suspense.

More importantly, it will tell you that the IVF clinic you chose was incompetent, and you can then spend time finding a better clinic !

And it's true that some Day 3 embryos  do implant, and it's also true that not every blastocyst is going to implant, but the probability of a blastocyst implanting is much higher !

Doesn't it make sense to maximise your chances ? Rather than reduce them because the lab is incompetent and doesn't have any confidence in its skills to culture embryos to Day 5 ( something which all good labs do routinely )

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !





The older woman's fertility. Comic/InfoGraphic

Thursday, July 15, 2021

The abnormal sperm morphology racket for over-reporting teratozoospermia [Video]

 

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Wednesday, July 14, 2021

Your embryo is safe in your uterus - like a pearl in an oyster [Video]

 

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Tuesday, July 13, 2021

How to get a 100% pregnancy rate after IVF? [Video]

 

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Monday, July 12, 2021

Why don't all doctors advice their patients to use the Malpani Self Insemination Baby Kit ? [Video]

 

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Sunday, July 11, 2021

Ovulation - the key event in the woman's fertility cycle. Comic/InfoGraphic

 

Why did the doctor get such few eggs ? What every IVF patient needs to know



Each mature follicle normally contains 1 eggs, which means if you had 10 follicles on the ultrasound scan, you would expect the doctor to retrieve 10 eggs .However, if the number of eggs the doctors collects is much less than the number of follicles, this is the analysis you need to do to try to figure out what happened

Before the egg collection, you need to find out how many mature follicles there are on your ultrasound scan , and what your blood estradiol ( E2) level is. Tragically, we find that many doctors don't bother to share this information - and patients don't even ask . This ignorance can be a huge problem , and that's why you need to be actively involved in your treatment . Ask these questions during each scan, rather than after you find out that the doctor wasn't able to retrieve as many eggs as expected, because by that time, the damage has already been done

 Sometimes the doctor isn't able to collect any eggs at all .

This can happen when the follicles rupture before he gets around to doing the egg collection. This can happen when clinics schedule a large number of egg collections in one day, as a result of which they start running late.

Another reason for not getting any eggs is called Empty Follicle Syndrome . This is an iatrogenic problem, and occurs if the HCG injection is not given properly . You can read more about this distressing situation , which is preventable, at https://www.drmalpani.com/knowledge-center/articles/about-the-empty-follicle-syndrome

 It’s far commoner that the doctor does get eggs, but these are much fewer than the number of follicles. A common problem is very busy corporate clinics is there are in a rush to do as many IVF procedures as possible, in order to maximize their income. This means they spend only 5 minutes doing a pickup – and some take perverse pride in how fast they are , and how quickly they finish the procedure . What this means is that they are not systematic , and even though there are eggs in your follicles , they don't take the time and trouble to collect them all. This is especially true of you have adhesions around your ovaries . The doctor then claims the ovary was inaccessible , but this actually means that the doctor was technically incompetent, and didn't spend devote enough energy and patience in collecting all your eggs . This is completely unfair on you , because his rushed carelessness means your chances of getting pregnant have dropped significantly.

 Another problem we sometimes find is that doctors aren't honest with their patients. This means that even though they collect a large number of eggs, they lie to the patient, and “donate” the “extra eggs” to another patient.

They can get away with this unethical and illegal practice because patients are clueless . This lie allows them to maximize their income , because they can collect fees from both the patients.

The tragedy is that clinics routinely get away with this , which is why you need to be actively involved in what's happening to you during your treatment.

 And finally the problem sometimes may not be with the doctor, but with the embryologist . If he is not well trained , he may not be able to identify the eggs ( for example, because his microscope is of poor quality) . This is why it's so important that you select a clinic which has both an experienced IVF specialist as well as expert embryologist , who work well together, and will spend as much time, energy and expertise required to maximize the number of eggs they collect for you.

The more the eggs you get, the more the embryos you will have , and this will maximize your chances of getting pregnant !

 

How to make sense of a medical second opinion from IVF experts? [Video]

 


Friday, July 09, 2021

Painfree IVF - Why IVF at Malpani IVF clinic is painfree [Video]

 

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 Need help? We provide a second opinion on all infertility issues. Please send us your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so that we can guide you better.

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